University of Pittsburgh Medical Center, Pittsburgh, PA.
Cancer Prevention and Control Section, Michigan Department of Health and Human Services, Lansing, MI.
JCO Oncol Pract. 2020 Jun;16(6):e549-e556. doi: 10.1200/JOP.19.00296. Epub 2020 Jan 29.
Although smoking by patients with cancer and survivors causes adverse outcomes, many patients with cancer do not receive access to evidence-based tobacco use treatment. The purpose of this article is to report on delivery of tobacco use treatment to patients with cancer using a state-supported Quitline.
Statewide agencies in Michigan partnered with the Michigan Oncology Quality Consortium to develop and implement a clinical quality improvement initiative with the goal of addressing tobacco use by patients with cancer across Michigan oncology practices. The collaborative designed an opt-out approach for identifying tobacco users and referring them to the Michigan Tobacco Quitline (hereafter known as Quitline) within participating practices. As the initiative progressed, patients with cancer who were not referred through the initiative also became eligible for enrollment in the Quitline program.
A total of 4,347 patients with cancer enrolled in the Quitline between 2012 and 2017, and annual referrals from oncology practices increased from 364 (5% of Quitline participants) to 876 (17% of Quitline participants). The 2013-2016 Michigan Behavioral Risk Factor Surveillance System also demonstrated an increase from 60% to 80% of cancer survivors receiving smoking cessation resources. Of 3,892 patients with cancer who had Quitline follow-up data through 2017, 79% completed one or more counseling calls. The 6-month self-reported quit rate for patients with cancer assessed between 2013 and 2016 was 26%.
Using statewide resources to increase access to evidence-based smoking cessation assistance to patients with cancer is achievable. In an increasingly cost-conscious health care environment, collaborative initiatives that use or enhance existing resources should be considered and refined to deliver effective evidence-based care.
尽管癌症患者和幸存者吸烟会导致不良后果，但许多癌症患者无法获得基于证据的烟草使用治疗。本文旨在报告使用州支持的戒烟热线为癌症患者提供烟草使用治疗的情况。
密歇根州的全州机构与密歇根肿瘤质量联盟合作，制定并实施了一项临床质量改进计划，旨在解决密歇根州肿瘤学实践中所有癌症患者的烟草使用问题。该合作组织设计了一种默认方式来识别烟草使用者，并将他们转介到参与实践中的密歇根州烟草戒烟热线（以下简称戒烟热线）。随着该计划的推进，未通过该计划转介的癌症患者也有资格参加戒烟热线计划。
2012 年至 2017 年间，共有 4347 名癌症患者参加了戒烟热线，来自肿瘤学实践的年度转介从 364 人（戒烟热线参与者的 5%）增加到 876 人（戒烟热线参与者的 17%）。2013-2016 年密歇根州行为风险因素监测系统还表明，接受戒烟资源的癌症幸存者比例从 60%增加到 80%。截至 2017 年，有 3892 名癌症患者有戒烟热线随访数据，其中 79%完成了一次或多次咨询电话。在 2013 年至 2016 年期间评估的癌症患者的 6 个月自我报告戒烟率为 26%。
利用全州资源为癌症患者增加获得基于证据的戒烟援助的机会是可行的。在日益注重成本的医疗保健环境中，应考虑并完善利用或增强现有资源的合作计划，以提供有效的基于证据的护理。
